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Ellis KL, Contino EK, Nout‐Lomas YS. Poor performance in the horse: Diagnosing the non‐orthopaedic causes. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Katherine L. Ellis
- Gail Holmes Equine Orthopedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
| | - Erin K. Contino
- Gail Holmes Equine Orthopedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
| | - Yvette S. Nout‐Lomas
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
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Reef VB, Davidson EJ, Slack J, Stefanovski D. Hypercapnia and hyperlactatemia were positively associated with higher-grade arrhythmias during peak exercise in horses during poor performance evaluation on a high-speed treadmill. Vet J 2020; 266:105572. [PMID: 33323171 DOI: 10.1016/j.tvjl.2020.105572] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 10/09/2020] [Accepted: 11/02/2020] [Indexed: 01/21/2023]
Abstract
Cardiac arrhythmias are common in horses during exercise, especially immediately post-exercise. The objectives of this study were to: (1) describe the frequency and type of cardiac arrhythmias detected in horses during incremental high-speed treadmill exercise testing (ITET); (2) determine if arterial blood gas (ABG) changes at peak and immediately post-exercise were associated with arrhythmias; and (3) determine whether upper or lower airway disease was associated with exercising cardiac arrhythmias. Horses (n = 368) presenting for an ITET underwent resting and exercising upper airway endoscopy, resting, exercising and post-exercise electrocardiography, resting and post-exercise echocardiography and exercising ABG. Arrhythmias were graded by the most severe arrhythmia present. Grade 1 arrhythmias were defined as one or two atrial (APCs) or ventricular premature complexes (VPCs), or one APC and one VPC, detected in 6.9% at peak and 16% at 0-2 min post exercise.. Grade 2 arrhythmias were >2 APCs or VPCs, or both, detected in 5.8% at peak and 16.6% at 0-2 min post exercise. Grade 3 included complex arrhythmias (couplets, triplets, R on T, multiform complexes or paroxysmal atrial or ventricular tachycardia), detected in 4.4% at peak and 7.3% at 0-2 min post exercise. Both partial pressure of arterial CO2 (PaCO2; P = 0.008) and lactate (P = 0.031) were significantly associated with arrhythmias occurring at peak exercise, but not immediately post-exercise. As PaCO2 and lactate increased, arrhythmia severity increased. Blood pH was significantly associated with grades 2 and 3 arrhythmias at 0-2 min post ITET (OR = 0.0002; P < 0.001). There was no significant association between grades 2 and 3 cardiac arrhythmias, inflammatory airway disease (IAD), or exercise-induced pulmonary hemorrhage (EIPH). When adjusted for lactate concentration (P = 0.06), higher PaCO2 concentrations in horses with and without exercising upper respiratory tract (URT) obstruction were associated with higher likelihood of grades 2 and 3 arrhythmias (P < 0.01). This study demonstrated that at peak exercise, with severe hypercapnia and hyperlactatemia, there was increased risk for grades 2 or 3 cardiac arrhythmias and, as the PaCO2 and lactate values increased further, the severity of those arrhythmias increased.
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Affiliation(s)
- V B Reef
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, 382 West Street Rd., Kennett Square, PA 19348, USA.
| | - E J Davidson
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, 382 West Street Rd., Kennett Square, PA 19348, USA
| | - J Slack
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, 382 West Street Rd., Kennett Square, PA 19348, USA
| | - D Stefanovski
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, 382 West Street Rd., Kennett Square, PA 19348, USA
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Fretheim-Kelly ZL, Halvorsen T, Clemm H, Roksund O, Heimdal JH, Vollsæter M, Fintl C, Strand E. Exercise Induced Laryngeal Obstruction in Humans and Equines. A Comparative Review. Front Physiol 2019; 10:1333. [PMID: 31736771 PMCID: PMC6831747 DOI: 10.3389/fphys.2019.01333] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 10/07/2019] [Indexed: 12/03/2022] Open
Abstract
Dynamic obstructions of the larynx are a set of disorders that occur during exercise in equines and humans. There are a number of similarities in presentation, diagnosis, pathophysiology and treatment. Both equines and humans present with exercise intolerance secondary to dyspnea. During laryngoscopy at rest, the larynx appears to function normally. Abnormalities are only revealed during laryngoscopy at exercise, seemingly triggered by increased ventilatory demands, and quickly resolve after cessation of exercise. Lower airway disease (asthma being the most prevalent condition), cardiac disease and lack of fitness are the major differentials in both species. Laryngoscopic examination during exercise should be performed from rest to peak exertion to allow for a comprehensive diagnosis, including where the airway collapse begins, and thereafter how it progresses. Dynamic disorders with most visual similarity between humans and equines are: aryepiglottic fold collapse (both species); equine dynamic laryngeal collapse (DLC) relative to some forms of human combined supraglottic/glottic collapse; and epiglottic retroversion (both species). Quantitative grading techniques, such as airway pressure measurement, that have proven effective in veterinary research are currently being piloted in human studies. Conditions that appear visually similar are treated in comparable ways. The similarities of anatomy and certain types of dynamic collapse would suggest that the equine larynx provides a good model for human upper respiratory tract obstruction during exercise. Thus, close collaboration between veterinarians and medical personal may lead to further advancements in understanding pathophysiologic processes, and enhance the development of improved diagnostic tests and treatments that will benefit both species.
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Affiliation(s)
- Zoe Louise Fretheim-Kelly
- Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Oslo, Norway.,Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Thomas Halvorsen
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Hege Clemm
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Ola Roksund
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.,Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - John-Helge Heimdal
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway.,Department of Oral Surgery, Haukeland University Hospital, Bergen, Norway
| | - Maria Vollsæter
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Constanze Fintl
- Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Oslo, Norway
| | - Eric Strand
- Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Oslo, Norway
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McKenzie E. Foundations of performance – factors that contribute to excellence in equine exercise. COMPARATIVE EXERCISE PHYSIOLOGY 2017. [DOI: 10.3920/cep170022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Horses are renowned for their incredible capacity for a range of athletic activities, and participation in athletic events arguably represents the most critical strut of the equine industry. Successful performance is typically a primary focus during participation in competitive athletic events, and relies upon a variety of innate physiological and structural factors of the athlete. However, a wide range of external factors also influence performance, and many of these can be readily manipulated. Therefore, thorough assessment of the individual’s inherent capacity for a specific athletic discipline must be combined with optimisation of external factors including nutrition and training to promote excellent performance. Recent progress in methods of athlete selection and monitoring of training responses are assisting continued improvements in equine performance.
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Affiliation(s)
- E. McKenzie
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, 227 Magruder Hall, Corvallis, OR 97331, USA
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Franklin SH, Allen KJ. Assessment of dynamic upper respiratory tract function in the equine athlete. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12432] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S. H. Franklin
- School of Animal and Veterinary Sciences; University of Adelaide; Roseworthy Australia
| | - K. J. Allen
- Equine Sports Medicine Centre; University of Bristol; UK
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Barnett TP, Smith LCR, Cheetham J, Barakzai SZ, Southwood L, Marr CM. A call for consensus on upper airway terminology. Equine Vet J 2015; 47:505-7. [DOI: 10.1111/evj.12468] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | | | | | - C. M. Marr
- EVJ Editorial Office; Ely Cambridgeshire UK
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